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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Angela Nurini Agni
Departemen Ilmu Kesehatan Mata, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada – Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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The risk of elevated plasma fibrinogen level in hypertensive and normotensive patientsafter bevacizumabintravitreal injection in diabetic retinopathy Ni Luh Putu Widhyasti; Anik Ika Winarni; Natalia Christina Angsana; Rizto Wisuda Senuari; Angela Nurini Agni; Agus Supartoto; Suhardjo Prawiroranu; Tri Wahyu Widayanti; Tatang Talka Gani; Usi Sukorini
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 1 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (282.269 KB) | DOI: 10.19106/JMedSci005201202007

Abstract

Bevacizumab intravitreal injection (IVB) could be detected in plasma that might cause an imbalance in the coagulation system. A hypercoagulable state is potentially involved in the risk for thrombosis, which is associated with high cardiovascular mortality.The objective of the current study was to investigate the risk of elevated plasma fibrinogen levelsin hypertensive and normotensive patients after IVB in diabetic retinopathy. This study was conducted at Dr. Sardjito General Hospital, Yogyakarta from March to June 2019. A total of 64 patients were enrolled in the study, included of 32 hypertensive and 32 non-hypertensive patients with diabetic retinopathy who underwent IVB. Patients were interviewed and investigated for physical condition and opthalmological examination. Fibrinogen levelwas measured before and 1 week after IVB. The mean fibrinogen level beforeand after IVB was slightly high in hypertensive patients than normotensive but not significantly different(p>0.05). There was no significant risk of increased fibrinogen levels after IVB in the hypertension group compared to the normotension group in diabetic retinopathy patients. The proportion of patients at high risk for cardiovascular disease after IVB was not significantly different between both groups.
Evaluation of The Clinical Supervision to Clinical Rotation Students In a Faculty of Medicine Irwan Ashari; Titi Savitri Prihatiningsih; Angela Nurini Agni
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 6, No 2 (2017): JULI
Publisher : Asosiasi Institusi Pendidikan Kedokteran Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.329 KB) | DOI: 10.22146/jpki.32258

Abstract

Background: The clinical education at the Faculty of Medicine, University of Muhammadiyah Makassar, must be completed in four semesters. During that period, the students are educated and supervised by specialists or doctors on duty at the hospital. Since the first implementation of the clerkship clinical system at this university, evaluation on the implementation of clinical supervision provided by lecturers to the students for their clinical clinic had never been conducted. Therefore, it was necessary to evaluate the clinical supervision provided by the clinical instructor to the students for their clinical clerkship at FK-Unismuh. This study aims to evaluate the clinical supervision provided by lecturers to the clinical clerkship students at FK-Unismuh Makassar.Method: This study was a descriptive survey. The subjects were 123 clinical clerkship students of FK-Unismuh Makassar who had completed clinical rotation at the department of Internal Medicine, Pediatric, Surgery, and Obstetrics and Gynecology. The research subjects were grouped based on their clinical rotation that had been undertaken. The instruments used were the Clinical Teaching Effectiveness Instrument (CTEI) and the students’ log book for their clinical activities. The collected data were analyzed descriptively.Results: The effectiveness of clinical supervision showed that the overall average total score of CTEI was more than 3 with a range from 3.52 (internal medicine) to 3.84 (surgery). The lowest clinical supervision was at setting up a good time for both services and teaching (3.50). The average frequency of supervision received in Internal Medicine was 91.2 times. The average number of timely, late, and delayed supervision was 40 times (44%), 23 times (26%), and 28 times (30%), respectively. The average supervision duration of under 30 minutes, 30-60 minutes, and more than 60 minutes was 63 times (69%), 16 times (18%), and 12 times (13%), respectively.Conclusion: The effectiveness of the overall clinical supervision at 4 departments was rated ‘good’ by clerkship students. However, there were some items of the clinical supervision which were still undervalued by the students. At the Department of Internal Medicine, the number of students accepted uneven supervision, much clinical supervision was carried out not on time, and duration of supervision was inadequate.
Surgical Technique of Late Spontaneous IOL-Capsular Bag Complex Dislocation with Low Corneal Endothelial Cell Density: A Case Report Firman Setya Wardhana; Dhimas Hari Sakti; Supanji Supanji; Muhammad Bayu Sasongko; Tri Wahyu Widayanti; Angela Nurini Agni
International Journal of Retina Vol 2 No 1 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss001.54

Abstract

Introduction: IOL-capsular bag complex dislocation is a rare but serious complication of phacoemulsification surgery. Technique to repair this complication should be based on various clinical parameters including quality of corneal endothelial cells and the type of dislocated IOL. Case Presentation: We present a case of a 67-year-old male with left eye spontaneous one-piece foldable IOL-capsular bag complex dislocation to vitreous cavity 4 years after phacoemulsification surgery. Visual acuity of the left eye was 1/60, pupil was round with 3 mm diameter and IOP was 15 mmHg. Noncontact specular microscopy examination showed that the corneal endothelial cell density was 1100 cells/mm2. It was managed with 23-gauge posterior vitrectomy, IOL evacuation to anterior chamber, releasing the capsular bag and repositioning the IOL into posterior chamber by sutured scleral fixation. Result: Follow-up at 6thmonth, best corrected visual acuity of the left eye achieved 6/6, IOL at central position and the last corneal endothelial cell density was 1076 cells/mm2. Conclusions: Late spontaneous IOL-capsular bag complex dislocation with low corneal endothelial cell density can be safely managed with proper surgical technique. Vitrectomy and sutured scleral fixation of the previously dislocated IOL were effective in managing such case. Longer follow-up should be done to assure the stability of IOL position and the quality of corneal endothelial cells.
CENTRAL MACULAR THICKNESS REDUCTION AFTER INTRAVITREAL INJECTION OF BEVACIZUMAB COMPARED TO INTRAVITREAL KETOROLAC IN NAIVE DIABETIC MACULAR EDEMA Supanji Supanji; Angela Nurini Agni
International Journal of Retina Vol 5 No 2 (2022): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2022.vol005.iss002.203

Abstract

Introduction: Diabetic macular edema (DME) is a debilitating complication of the diabetic eye. Vascular Endothelial Growth Factor (VEGF) was found to be responsible for this disease entity, and anti-VEGF remains the main treatment of DME. Inflammatory processes occur in diabetic eye, with some researchers postulates the role of them in the making of DME. This study’s objective is to search for anti-VEGF alternative using Non-Steroid Anti-Inflammatory Drugs (NSAID), ketorolac tromethamine. Methods: We conducted a double blind, randomized clinical trial in DME patients using intravitreal injection of bevacizumab and ketorolac. Central macular thickness (CMT) was assessed pre-treatment and one-month post-treatment. Best Corrected Visual Acuity (BCVA) and Intraocular Pressure (IOP) were also assessed. Wilcoxon tests were performed to evaluate changes in CMT, visual acuity, and IOP. Result: We enrolled 50 treatment-naïve DME patients from March 2020 to March 2021. Twenty-five patients were allocated for each group. There is a statistically significant difference in CMT at one-month follow-up between the two groups (p:0.001) and a markedly reduced CMT between the groups (p:0.001), with the reduction higher in bevacizumab group. BCVA changes significantly in bevacizumab group (p:0.01), but there is no statistically significant difference between the two groups (p:0.07). There’s a marked difference of IOP in 1 hour after injection in both groups, with higher transient IOP elevation in ketorolac group (p:0.02), but there is no marked difference in one-month follow-up (p:>0.05). The perceived pain right after intravitreal injection is not different between bevacizumab and ketorolac group. Conclusion: Intravitreal injection of ketorolac found to be inferior compared to bevacizumab in reducing CMT of DME. Meanwhile, there’s no differences in visual acuity, intraocular pressure (one-month follow-up) and pain after injection between two groups.
Shortening Activated Partial Tromboplastin Time (APTT) Between Hypertension and Nonhypertension in Diabetic Mellitus Patients with Bevacizumab Intravitreal Injection Anik Ika Winarni; Ni Luh Putu Widyasti; Natalia Christina Angsana; Rizto Wisuda Senuari; Angela Nurini Agni; Agus Supartoto; Muhammad Bayu Sasongko; Haryo Yudono
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.98

Abstract

Introduction : Bevacizumab intravitreal injection could be detectable in plasma that might interfere the coagulopathy and hemostasis condition. The purpose of this study was to investigate the difference of APTT between hypertensive and nonhypertensive diabetic mellitus patients with bevacizumab intravitreal injection. Methods : This was cohort study conducted at Sardjito General Hospital from March 2019 to June 2019. Thirty-two hypertension patients and 30 nonhypertension patients with diabetes mellitus who underwent bevacizumab intravitreal injection were included. Value of APTT was measured using ACLTOP300 machine prior and 1 week after IVB. The difference in mean APTT value prior and after IVB, range APTT value between two groups were assessed using independent t-test. The percentage of patients who had shortening of APTT in both groups was tested by two populations proportion test. Results : Mean APTT before IVB in hypertensive patients was 36.47 ± 2.92 seconds and in nonhypertensive patients was 36.33 ± 4.39 seconds with p value > 0.05. Mean value of APTT after IVB in hypertension patients was 35.42 ± 3.63 seconds and in nonhypertensive patients was 35.60 ± 3.13 seconds with p value > 0.05. APTT shortening in hypertensive patients was -1.03 ± 3.65 and nonhypertensive patients was -0.73 ± 2.55 with p value > 0.05. The risk of APTT shortening in hypertensive patients was 1.370 (0.831-2.258). The risk of APTT shortening in hypertensive patients who used antihypertensive drugs regularly was 0.538 (0.331- 0.874). Conclusion : There was no difference in shortening of APTT value 1 week after intravitreal bevacizumab injection between hypertensive and nonhypertensive groups in patients with diabetes mellitus. Hence, administration of IVB in hypertensive patients with regular antihypertensive therapy might be safe.
Comparing Myopic Progression in Urban and Rural Junior High School in Yogyakarta Widya Prafitri Rasmiyati; Suhardjo Suhardjo; Angela Nurini Agni
Majalah Oftalmologi Indonesia Vol 42 No 1 (2016): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v42i1.71

Abstract

Background: To compare myopic progression rates in junior high school in Yogyakarta betweenurban and rural areas.Methods: A school-based survey was initially conducted. Five junior high schools were selected inboth urban and rural areas. A longitudinal follow up study was conducted 1 year later. Age range from12 to 15 years old. The refractive state of each student was measured with autorefractometer.Results: A total of 195 junior high school children participated in the study. One hundred and ninteenchildren were from urban area and 76 children came from rural area. A follow up study after 1 year,mean myopic progression in junior high school in urban area was around 0.5 D/year faster than in rural,which was 0.37 D/year. There were statistically significant difference in nearwork activities betweenchildren in urban and rural areas, with p=<0.001. Risk factor such as gender and myop status of parentsdid not relate with myop progression, only age and sosioeconomic had significant effect into the myopprogression. Mean myopic progression in junior high school children (age 12-15) in the urban area wasaround -0.50 D/year. The average progression rate was fastest in 14 years old.Conclusion: There is significant difference in increasing of myop progression between junior highschool children in urban and rural areas. This difference may be related to difference of nearworkactivities between children in urban and rural areas. Keywords: myopia, urban, rural, myop progression, junior high school
Efek Penambahan Natrium Diklofenak Topikal pada Terapi Injeksi Intravitreal Bevacizumab terhadap Perubahan Visus dan Tekanan Intraokular Pasien dengan Edema Makula Diabetika Supanji Supanji; Widya Ramania; Melvina Nidya Sandra; Angela Nurini Agni; Suhardjo Suhardjo; Retno Ekantini; Muhammad Bayu Sasongko
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v49i2.100270

Abstract

Introduction dan Aim: Diabetic Macular Edema (DME) in Diabetic Retinopathy (DR) patients might threaten the patient's visual acuity. Therefore, a robust DME treatment is needed to prevent sight threatening condition in DR patients. In this study, we intended to compare the effects of intravitreal administration of bevacizumab versus bevacizumab and topical natrium diclofenac in DR patients who developed DME. Methods: This was a randomized controlled trial study with double blinds. Data were taken from April 2020 to June 2021 from the Dr. Sardjito Central General Hospital and the Dr. Suhardi Hardjolukito Indonesian Air Force Central Hospital, Yogyakarta. Our patients were assigned to a control group (intravitreal bevacizumab therapy only) and an intervention group (intravitreal bevacizumab and topical natrium diclofenac). Then, we evaluated best corrected visual acuity (LogMar) and intraocular pressure (IOP, mmHg) were recorded in both groups before and after therapy. Results: A total of 38 eyes from 36 patients with naive DME were included in this study. Both treatment groups showed a statistically significant improvement in visual acuity after treatment bevacizumab (pre = 0.8±0.5; post = 0.6±0.5; p-value = 0.033) and bevacizumab and natrium diclofenac (pre = 0.9±0.5; post = 0.5±0.3; p-value = 0.004). In contrast to the above findings, the IOP in both groups did not show a significant change in IOP after therapy, bevacizumab (pre = 15.7±4.1; post = 15.6±4.2; p-value = 0.810) and bevacizumab and natrium diclofenac (pre = 16.0±4.5; post = 16.0±3.9; p-value = 0.868). Conclusion: Our study showed that visual acuity was improved significantly in DME patients treated with either bevacizumab or bevacizumab and natrium diclofenac. This might be a valuable information on the improvement of DME therapy, given that no increased post-therapy IOP in patients treated topical natrium diclofenac.
Co-Authors Agus Supartoto Anik Ika Winarni Anik Ika Winarni Dhimas Hari Sakti Firman Setya Wardhana Haryo Yudono Irwan Ashari Melvina Nidya Sandra Muhammad Bayu Sasongko Muhammad Bayu Sasongko Natalia Christina Angsana Natalia Christina Angsana Ni Luh Putu Widhyasti Ni Luh Putu Widyasti Retno Ekantini Rizto Wisuda Senuari Rizto Wisuda Senuari Suhardjo Prawiroranu Suhardjo Suhardjo Suhardjo Suhardjo Supanji Supanji Supanji Supanji Tatang Talka Gani Titi Savitri Prihatiningsih Tri Wahyu Widayanti Usi Sukorini Widya Prafitri Rasmiyati Widya Ramania